Unnatural sudden infant death

Abstract

Aim-To identify features to help paediatricians diVerentiate between natural and unnatural infant deaths.Method-Clinical features of 81 children judged by criminal and family courts to have been killed by their parents were studied. Health and social service records, court documents, and records from meetings with parents, relatives, and social workers were studied. Results-Initially, 42 children had been certified as dying from sudden infant death syndrome (SIDS), and 29 were given another cause of natural death. In 24 families, more than one child died; 58 died before the age of 6 months and most died in the afternoon or evening. Seventy per cent had experienced unexplained illnesses; over half were admitted to hospital within the previous month, and 15 had been discharged within 24 hours of death. The mother, father, or both were responsible for death in 43, five, and two families, respectively. Most homes were disadvantaged-no regular income, receiving income support-and mothers smoked. Half the perpetrators had a history of somatising or factitious disorder. Death was usually by smothering and 43% of children had bruises, petechiae, or blood on the face. Conclusions-Although certain features are indicative of unnatural infant death, some are also associated with SIDS. Despite the recent reduction in numbers of infants dying suddenly, inadequacies in the assessment of their deaths exist. Until a thorough postmortem examination is combined with evaluation of the history and circumstances of death by an experienced paediatrician, most cases of covert fatal abuse will go undetected. The term SIDS requires revision or abandonment. (Arch Dis Child 1999;80:7-14)

The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk

“…[131][132][133] However, on the basis of an in-depth review of recurrent sudden unexpected infant deaths among families that had experienced 1 SIDS death, Carpenter et al 134 calculated an 87% probability that a second SIDS death within a family would be of natural cause. Calculations of the proportion of SIDS deaths attributable to covert homicide range from 6% to 10%, and recurrence risks for SIDS within a family in which 1 infant previously died of SIDS range from 2% to 6%.…”

Ani Bebek Ölümü Sendromu

“…‹lk kez 1969 y›l›nda, "herhangi bir infant ya da küçük çocukta, hikayesi ile beklenmeyen, tüm postmortem incelemelerle ölüm nedeni aç›klanamayan ani ölüm" fleklinde tan›mland› (5,12). 1979 y›l›nda, "The ninth edition of the International Classification of Disease (ICD-9)'da "Sudden infant death syndrome-798."…”

“…Özellikle tekrarlayan bebek ölümlerinde, "Munchausen syndrome by proxy", öldürücü çocuk istismar› ve bo¤ulan bebekler de ak›lda tutulmal›d›r (12,14,50,62,63). Asfiktik ölümlerde görülen intratorasik petefliyal ve intraalveoler kanamalar, ABÖS olgular›nda da görülmek-tedir.…”

Distinguishing Sudden Infant Death Syndrome From Child Abuse Fatalities

“…Recent literature has suggested that the index of suspicion for unnatural death should be higher, particularly in families in which an unexplained infant death has occurred previously. 34 More recent publications, however, provide some reassurance that a percentage of recurrent, unexplained infant deaths may be, in fact, natural. 35,36 Estimates of the incidence of infanticide among cases designated as SIDS range from less than 1% to 5%.…”